“It’s Just Another Genetic Mutation”

Before the 🦷 came out!

Back in March, we took the kids for their first dental checkup of 2022. At the time, we knew Greyson had a single cavity on the bottom right side of his mouth, but due to his behavior in the office, he was scheduled to have his cavity filled at CHOP in an operating room. After waiting for what felt like forever, Greyson was finally set to have his dental procedure on July 13th. We went into the procedure knowing that he had the one cavity, but had our suspicions about his front left tooth, which was injured in a fall last summer. The plan was for the team to go in after he was sedated, fill the cavity, do a thorough cleaning and check-up, and to get some X-rays, since the images the team got in office, weren’t so great due to Greyson’s behaviors. The entire procedure would last about 30-45 minutes, no problems, in and out quickly.

We left our home around 6:30 am for an 8 am check in, in Philadelphia. The traffic wasn’t too bad surprisingly, but finding a parking spot in the parking garage was a nightmare. Lots of construction in an already highly congested area, made for the WORST as soon as we got into University City. We did the ever so familiar process for checking in, going up to the surgical unit, sitting and waiting for his name to be called, then going back to his patient room. We ended up waiting around a bit in the room. It seemed like the unit was extremely busy and apparently it was mostly dental surgeries/procedures that were being done that day. I was already fairly exhausted after waking up at 4 am, so as soon as we got to a room, I was ready for a nap. We went through the motions of meeting with the nurses, doctors and anesthesiologist (who remembered me from Greyson’s VNS surgery in February-LOL), then waited for the team to bring in the Versed to be administered. We typically have great results with Versed, having used it several times before his other surgical procedures and MRI/CT scans, but this time, the medication didn’t work. This particular medicine is done via nasal spray and is usually fast-acting, but this time, Greyson was still extremely hyperactive and aggressive, even on his way back to the Operating Room.

Looking like a big boy waiting for his name to be called

Derek and I waited in the parent waiting area, where we were anticipating the procedure to be quick and fairly painless, however; after about an hour into the procedure, the lead doctor came out to speak with us. Pulling us aside into a private consult room, the doctor proceeded to tell us that Greyson’s teeth needed a LOT more TLC than initially thought. He not only had the large cavity on his bottom right side, but also several other cavities in between teeth throughout his mouth. He also required two crowns, several caps and multiple cavities to be filled. The icing on the top of the dental sundae, was that he had a genetic mutation, which caused him to have three top front teeth, rather than two. What’s another genetic mutation to add to his already too-long diagnosis listing…..

The doctor stated that the main front two teeth needed to come out, one because there was no room left for them since his additional tooth was already pushing down in through the roof of his mouth. WOOF. Luckily because every other child in the state of Pennsylvania was getting oral surgery done that day, there was an oral surgeon on the premises who was willing to surgically remove Greyson’s third tooth. The doctor showed us X-rays of the tooth and stated it had an abnormally very long root, which was another reason why it needed to be pulled. We agreed with the surgeons that we wanted this to be a one-time thing, so he wouldn’t need to be put under anesthesia again, which they agreed was a good idea. The surgery ended up lasting about 3 hours total, giving me time for a nap for about 45 minutes or so. When his surgery was finally over, the doctors gave us Greyson’s extra tooth (with the long root), and his other one front tooth, for us to keep. It was kinda weird to see how long the extra tooth was, in comparison to his other teeth, but very interesting. He took his good ol’ time coming out of his anesthesia, but once he was up, he was ready to go. Literally, taking off monitors, trying to pull out the IV, etc.

Post surgery

We got in the car and began the drive home. Traffic was a lot heavier getting out of Philadelphia, which surprised me because we were in the middle of the day. We were re-routed through several different areas on the Schuylkill, but finally got back onto the PA turnpike and headed home. His mouth is still healing, but he is sporting a LOT of silver in his mouth, and looks silly with no front teeth. Funny enough, his sister also has two front teeth missing, too- except hers just fell out to make room for the adult teeth coming in.

His front left tooth (on the right) and his extra tooth (left) with the extremely long root
Still a bit drowsy from the procedure on the next day

Since the dental procedure, Greyson has been doing much better eating certain foods and is more willing to eat things that he normally would not have even touched. This is the final week of his ESY (extended school year) services, which means that he will be off from a school setting until he goes back to school, for first grade at the end of August. I am eager to see how he will react once he gets back to the regular, predictable schedule of his normal school days. I for one will be extremely happy that he will be in school again for full days, and that his staff absolutely adore him.

Roslynn is completing her last week of summer school, which was an optional program Derek and I decided to enroll her in, so she could continue her education over the summer. She had previous help in school with her reading and math skills, so we wanted to make sure that she had the concepts and skills fresh in her mind for the next school year, and second grade. She has spent this summer playing outside, playing with her brother and friends, and she attends summer camp every other week for the month of July and first week of August. I have tried to spend as much time as possible with her, doing fun Mom and daughter stuff, since we don’t get much time together alone over the school year. We most recently did a dinner theatre show of “The Little Mermaid” at the Dutch Apple Theatre, which we both really enjoyed! It’s hard to believe that she is going into second grade, and that there are only a few short weeks left in the summer- it always flies by so quickly.

After the show!
Getting Ice Cream at the new Fox Meadows

Our family is taking our first post-Covid vacation in August, and I am absolutely terrified of how Greyson will be while we are in a new setting. I have researched all sorts of safety things, ways to keep him occupied in the car for 12+ hours, and what types of accommodations we needed at the house we are staying at. I’m looking forward to late nights out on the balcony, watching/listening to the ocean, and am hoping to find some time to relax and enjoy the week. My family always takes a large family vacation every other year, so this has been long overdue with COVID and my mom’s illness. I am still finding it hard to believe that she will not be on the trip with us (physically at least). The beach was my Mom’s happy place, much like it is mine. It will be weird heading to the beach and not having her there to make fun of me for not going in the ocean past my ankles (sharks, duh), and laughing at me because I hide from the sun (gingers do not like sunlight). I do look forward to relaxing on the beach with the salt water smell in the air, a pina colada in one hand, and a book in the other. This is all hoping that Greyson will be okay in the ocean/pool, if we all survive the car ride there. Fingers crossed!

South Carolina ❤️
Greyson’s ready to pack up for the beach!

Holy Spirit, Activate!

In case you’ve been living under a rock and don’t get the title of the post

Tuesday, March 8th was Greyson’s VNS activation day. As I’ve said in previous posts, his VNS voltage level will be slowly increased over the next 12-16 weeks, until we are at a level that will work for him. The neurologist isn’t expecting us to really notice any change or improvement yet, since the device is on the lowest setting currently.

Tuesday, Greyson and Derek had a follow-up with the neurologist, who said Greyson’s incisions were healing well and again reiterated that we most likely will not see the benefits of the device quite yet. The doctor said that we only really needed to contact her if we noticed any side effects.

Not being able to attend the appointment, I gathered all the info about how to use the device, from Derek. He showed me how to use the magnets across his chest, in case of a seizure, and also explained to me that the device runs for 30 seconds every 5 minutes.

I was a little confused, wondering how I would know when the device is running for the 30 seconds, but I caught on quickly. Every 5 minutes, Greyson turns into a mini Chewbacca. Seriously. He vocalizes and because the lead from the device is wrapped around his vagus nerve, extremely close to the vocal folds, he makes an odd Chewbacca-like throat purr. It’s actually really funny to hear, but also good to know if the device is working more than every 5 minutes, to prevent a seizure. It’s almost like a little warning that one may be coming, so that’s helpful.

The first evening with the activated VNS, Greyson had a partial tonic-clonic seizure. Not feeling too optimistic that the magnet would help (due to the low voltage), I started the timer while Derek ran to grab a magnet and the emergency med. To sum the process up, the magnet is held over the device (in Greyson’s chest) for 2 seconds. Anything over 2 seconds shuts the device off. We can use the magnet two times, one minute apart each time. If the magnet does not stop the seizure, we use the Diastat suppository to stop the seizure. Derek held the magnet over the device and within 10 seconds, Greyson stopped seizing. I was in complete disbelief. It actually worked!

The next seizure happened Friday evening. Same situation- Greyson began to seize and within 30 seconds of the start, we used the magnet. This time though, the magnet wasn’t working. We tried again a minute later and luckily, Greyson stopped seizing. The two seizures he has had this week, each lasted under 5 minutes total. A week ago, Greyson’s seizures were lasting up to 30-45 minutes each. His emergency medicine isn’t working as well to stop his seizures, but I am hopeful that once the voltage of the VNS increases, we will really start seeing more of the magnet and less of the medication.

As if Tuesday wasn’t eventful enough, the kids both had dental appointments in Philadelphia, at UPenn. Roslynn, who swears she had no cavities because her teeth are white, had a clean bill of dental health. Greyson however, did not. I knew that Greyson had a cavity forming in his lower right side of his mouth, so I wasn’t surprised when the dentist said we would need to set up a visit to have his cavity filled. Unfortunately, Greyson is too aggressive to use the laughing gas on, so he will need to undergo dental surgery at CHOP. The wait for an appointment to get the cavity filled, is about 5-6 months, so we have to monitor his tooth and make sure it doesn’t become infected.

This kid just can’t catch a break.

Some times, I wish that I had a “normal” life, with kids that don’t require several appointments per week. I swear, the school Secretary is my personal truancy stalker. I’m shocked we haven’t received any notices yet regarding bringing the kids in late, picking them up early or keeping them home.

I guess eventually we will get him into the OR and they can fill the cavity, get some good X-rays and put some sealants on his teeth, so we can prevent this from happening again. Also, he really needs his extra tooth taken out (a weird genetic thing he inherited from my side of the family) before he loses baby teeth and the adult teeth come in all weird.

Guess for now while we wait, we continue to increase the VNS power and pray that it continues to work for our little man. Holy Spirit, activate! ….but really, cut him a break.

Raincoat

For the past year or so, Greyson has seen a local pediatric dentist, who works for a practice that isn’t the greatest with a non-verbal, autistic toddler. We began seeking a new dentist for him back in the fall of 2019 and were referred to the Penn Medicine Dental Program in Philadelphia. They do many “in home” procedures with laughing gas and they do sedated visits at CHOP, when needed. After the referral was placed, I was able to make sure they accepted his insurance (which had changed since his last appointment due to the loss of my benefits in April), which they did. Roslynn’s dentist (who Derek and I both see, along with the rest of my family) does not accept her new insurance, so I figured we would have her see someone at Penn Medicine too, since we were going to be there for Greyson. Today was the intake appointment for both children at the main campus in West Philadelphia.

The morning began as usual, with the exception that Greyson FINALLY slept in his own bed, for the first time in nearly two years! I was shocked. I woke up this morning, not knowing where we would find him, but I checked the clock at 7:30 AM and there he was, laying in his bed, snuggled under the covers, looking so cozy. I was hopeful that if he got a good night’s sleep, maybe he wouldn’t be a total grump at the dentist. Well, that hopeful thought lasted about an hour, because soon after waking up, he was not happy. Overall irritable, but energetic, so I was super confused. Alas, both kids were up, dressed and ready to go, so I felt like despite his attitude, maybe it would still be an okay trip.

Greyson sleeping in his BIG BOY BED!!!!!
Grumpy Greyson angry that he had to wear actual clothing today
I was convinced we were going to go to the ER instead of the dentist when he pulled this down onto himself…..

After many visits for CHOP for MRIs, EEGs and miscellaneous appointments, I knew that leaving early would be best for the sake of traffic and I always prefer to be early for appointments, just in case. So, like I typically do, I google mapped the location (for the 5th time) and route, along with the nearest parking garages and meter parking availability. I felt pretty confident that I knew where we were going and where to park, so I actually did not feel anxious for a “mini-trip”, like I typically am. That should have been my first warning that the day was not going to go as planned so easily. Greyson, who was the first appointment of the two kids, was scheduled for 1:00 PM and Roslynn was scheduled immediately after, at 2:00 PM. We left the house around 11:00 AM, stopping for gas before hopping on the highway. Roslynn and Greyson both had virtual psychiatry visits this morning at 9:15, and Roslynn was also scheduled for her weekly (virtual) outpatient appointment with her therapist at 11:15 AM. Luckily her therapist was okay with us doing the appointment in the car as we were driving, so Roslynn had her session in the back seat while I drove, Derek navigated and Greyson watched “Trolls”.

At the conclusion of her visit, Roslynn was starting to feel car sick, as she typically does when in the car, so I was giving constant reminders for her to breathe and close her eyes, etc. The GPS was reading an arrival time of 12:53 PM, so I was getting a little nervous that we weren’t going to have much time to get situated before we had to go in for the appointment. We got onto the Schuylkill Expressway and I felt like we were making pretty good time, despite traffic being a little heavy. We soon pass the exit for the Philly Zoo, CHOP and the Philly Convention Center, and I realized that I had never seen signs for Independence Hall before on our trips. The thought then crossed my mind that I had never seen Independence Hall before at all, until it was sitting right in front of me. I still continued to follow the GPS, just assuming that it was taking us on a short cut around construction. I began to get even more nervous when the GPS stated that our “location was approaching on the right side”, and we were sitting in front of a spa, tucked away in a busy city block, far into Center City.

This doesn’t look like the Penn Medicine Dental building

Panicked, I have Derek check the GPS address and he changed the GPS application we were using to good ol’ Google Maps. Turns out, the app we were using (which has never given me any issues before), took us to the other Penn Medicine Dental Program on the completely opposite side of the city. 12:53 PM came and went. I knew we would be really late, so Derek called and informed the receptionist that we were going to be late, to which she responded that we had “15 minutes past the appointment start time” as a grace period to get to the appointment. The GPS, with the correct location this time, was reading 1:10 PM arrival. Whew. I took a deep breath and got us across Philadelphia by 1:08 PM. We made it. I was so relieved. Traffic was getting heavy around the facility and there was no parking available out front of the building, so I dropped Derek and the kids off at the door and circled around the block to find a parking spot. About 20 minutes later, I finally got around the block and found a spot right in front of the building. I pay the $5.40 parking fee for two hours of parking and feel confident that maybe the trip wasn’t going to be a disaster afterall!

The Pediatric Dentistry program waiting room- super cute!!

I quickly go through the security check-in, get my temperature taken and smother Purel all over my hands and arms and join Derek and the children in the waiting room in the pediatric wing of the building. Greyson and Derek went back first for the first appointment. I sat in the waiting room with Roslynn and heard the occasional scream/cry come from the exam room that Greyson was in, so naturally I assumed all was going well. Back story to why I really wanted to find a dentist that could manage an ASD child, was because Greyson injured his mouth/front two teeth back in early 2020, when he head butted the steps the entire way down from the top step, to the bottom (pre-helmet arrival). His front right tooth had been turning a gray-ish color after the injury, so we were really upset that Penn Medicine wasn’t accepting new patients (due to COVID) from March until August. About 30 minutes later, Derek and Greyson come out of the exam room and into the waiting area, and the same dentist took Roslynn and I back to the same exam room.

Before we began with Roslynn’s exam, the dentist debriefed Greyson’s visit with me. Shockingly, Greyson had zero cavities! He did however, have an extra tooth growing in between his front two teeth. The gray tooth is in fact a dying tooth, as we expected. The dentist did not feel like it was necessary to pull the dead tooth at this time, mainly because it isn’t causing him any pain or discomfort at this time, and the dentist doesn’t want to give him anesthesia unless seriously necessary, which we agreed with. I was able to see the x-rays from G’s visit and saw the very crowded front teeth, 3rd tooth and all. Roslynn’s exam was fast and informative. She did great for her x-rays, cleaning and fluoride treatment, giggling at the dentist and dental assistant’s funny jokes the entire time. I knew that Roslynn had a cavity on her lower left side of her mouth, which was visible whenever she opened her mouth wide enough, but I was not prepared to hear that she had 5 additional cavities.

Roslynn has always been a great brusher. Every morning she always brushes her teeth after she is dressed and her hair is done. Evenings, she does need reminders and help with motivation to go into the bathroom and brush well, which she tries to avoid frequently. I would be lying if I didn’t say that I felt like a horrible parent when I heard that she had so many cavities. The dentist assured me that most of the cavities are between her teeth, mainly due to the fact that she has very little enamel on her teeth, which is a common issue with children. Basically any small teeny tiny evidence of a cavity beginning to form, Roslynn gets a full-blown cavity, quickly. The dentist stressed to Roz that she needed to allow us to help with her brushing and flossing. She reluctantly agreed, received her fluoride treatment and we set up her follow-up appointment to come in and have her cavities filled. We made a pit-stop at the bathroom before we began our 1 1/2 hour journey home and made our way to the exit.

I was so excited to show Derek what a great parking spot I got. Since both kids were getting pretty antsy and wanted to go home, Derek was relieved to hear that we wouldn’t have a far walk to get back to the car. We exit the building and I immediately noticed a bright orange piece of paper in the rear windshield wiper blade of my car. I at first believed that someone placed a flyer of some sort on the car, but didn’t see any other cars with any papers on them. As we approached closer to the car, a homeless man walked closer towards us and stated that the Philadelphia parking authority had been by, ticketed my car and marked it for towing. WHAT???!!!! I literally paid for parking, so I was so confused when I pulled the ticket and the bright orange paper off of the car. Having seen the show, “Parking Wars” on A&E, I knew that getting towed in a big city was something that you did NOT want. I quickly tell Derek and Roslynn to hurry up and get in the car, while I skim the car, looking for a boot that would prevent us from leaving. No boot. I thank the homeless man for his information and we pull away before a tow truck could come and move the car. Derek pulls the ticket out of the envelope and the $55.00 fine was written due to parking in an AMBULANCE spot. I honestly checked the signs when I was parking and saw zero signs regarding anything except “two-hour parking” and a loading zone a few feet away. Sitting at the red light feet away from the parking spot, Derek saw an ambulance loading/drop off sign that was in a spot close by the “3-hour handicapped” parking sign that I was looking at when I parked the car. I wanted to get out of the city and be done with the day, so we paid the ticket online and were done with the disaster of a day we had so far.

I swear, I can’t make this crap up. I have the BEST of luck.

Both kids were fairly hungry by 3:00 PM, so we stopped at an exit off the PA turnpike and got them some food. That held their crying over for about 20 minutes, until Greyson began to get fussy from sitting in the carseat. He was screaming and crying his high-pitched squealing cries that Derek and I just love so much. I was hitting some heavy traffic, so I was trying to calm Greyson down verbally, while paying attention the road and other drivers. Roslynn, who was complaining about motion sickness, was screaming for her raincoat, which we brought as a precaution. I asked her why she needed the raincoat, but of course, her anxiety and frustration of being in the car for so long, prevented her from answering me. She continued to scream “raincoat” the rest of the way home, which was about 45 minutes with the heavy traffic.

We got home finally around 5:00 PM, and were greeted happily by Mr. Duke. What a busy day. Both kids are out cold, just as I had hoped they would be. I love looking at them while they peacefully sleep, wondering what their little brains dream about at this age, (hopefully) not knowing the chaotic, challenging and uncertain times we are all facing as a nation. One thing I am certain of though, is I better not hear the word “raincoat” for awhile.